Influence of Kinesitherapy on Balance Reactions in Patients with Ischemic Stroke in the Chronic Period


  • Danche Vasileva University "Goce Delchev", Faculty of Medical Sciences, Shtip
  • Daniela Lubenova National Sports Academy, Physical Therapy and Rehabilitation, Sofia
  • Marija Mihova Ss Cyril and Methodius University of Skopje, Faculty of Computer Sciences and Engineering, Skopje
  • Antoaneta Dimitrova National Sports Academy, Physical Therapy and Rehabilitation, Sofia
  • Kristin Grigorova-Petrova National Sports Academy, Physical Therapy and Rehabilitation, Sofia



Kinesitherapy, Balance reactions, Ischemic stroke, Chronic period, Neurodevelopmental treatment, Physical activity


AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on balance reactions in patients with ischemic stroke in the chronic period (ISChP).

MATERIAL AND METHODS: A prospective, multicenter study with 56 patients with ISChP. Evaluation of balance reactions using Berg Balance Scale - BBS, includes implementation of 14 tasks with increasing difficulty reflecting the usual activities of everyday life. The first 5 assignments are used to assess the main balance potential and the remaining 9 (6th to 14th task) include more sophisticated balance tasks.

RESULTS: The patients were found with a significant improvement in balance opportunities, according to the scale of Berg. Compared to initial data there is a significant increase in the number of points in the measured indicators for functional and static balance. In absolute terms, positive change is most pronounced during the 1st month with a level of significance of p <0.001.

CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as adapted exercise program at home, and significantly improved equilibrium reactions in patients with postural disorders because of ischemic stroke and is with a supportive prolonged exposure.


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Intercollegiate Stroke Working Party. National clinical guideline for stroke, 4th edition. London, Royal College of Physicians, 2012. ISBN 978–1–86016–492–7 eISBN 978–1–86016–493–4.

Duysens J, Verheyden G, Massaad F, Meyns P, Smits-Engelsman B, Jonkers U, Rehabilitation of gait and balance after CNS injury. In Dietz V, Ward N, Oxford Textbook of Neurorehabilitation, Oxford University Press, 2015: 211-227 ISBN 978-0-19-967371-1.

Dietz V, Ward N, Oxford Textbook of Neurorehabilitation, Oxford University Press, 2015. ISBN 978-0-19-967371-1.

Morioka, S., Hiyamizu, M., Yagi, F. The effects of an attentional demand tasks on standing posture control. J Physiol Anthropol Appl Human Sci. 2005; 24:215-219. PMid:15930809

Shumway-cook A,Woolacott M. Motor control: Traslating research into clinical practice (3rd ed). Philadelphia: Lippincott Williams & Wilkins, 2006.

Dietz V, Berger W. Interlimb coordination of posture in patients with spastic paresis—impaired function of spinal reflexes. Brain. 1984;107:965-978. PMid:6478185

Pang M, Eng J, Dawson A, Gylfadottir S. The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: a meta-analysis. Clin Rehabil, 2006; 20(2):97-111. PMid:16541930 PMCid:PMC3167867

Hafer-Macko C, Ryan A, Ivey F, Macko R. Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies. Journal of Rehabilitation Research & Development. 2008;45(2):261–272.

National Stroke Foundation, Clinical Guidelines for Stroke Management. Melbourne: Australia, 2010. ISSBN0 – 978-0-9805933-3-4

Harvi R, Rot E, Ju D. Rehabilitation in stroke syndromes. In Bradom R, Physical medicine and rehabilitation. 3rd ed, Skopje: Tabernakul, 2011: 1175-1212. ISBN 978-608-210-197-2.

Brandstater M, de Bruin H, Gowland C, Clark B, Hemiplegic gait: analysis of temporal variables. Arch Phys Med Rehabil. 1983; 64:583-587. PMid:6661021

de Haart M, Geurts A, Dault M, Nienhuis B, Duysens J. Restoration of weight-shifting capacity in patients with postacute stroke: A rehabilitation cohort study. Arch Phys Med Rehabil. 2005;86(4):755-762. PMid:15827928

Dimitrova A, Lubenova D, Stefanova D, Simeonova A. Impact of kinesitherapeutic methodology on changes in static balance in patients with stroke in the vertebral-basilar system. Kinesitherapy. 2007; 3: 50-55.

Dimitrova A, Simeonova A, Grigorova K, Stefanova D. The influence of kinesitherapy over dynamic balance in patients with ischemic stroke in vertebral basilar system. Trakia Journal of Science. 2008; 6(2): 80 – 83.

Bobath B. Adult Hemiplegia: Evaluation and Treatment, 3rd ed. London: Heinemann Medical Books, 1990.

Lennon S, Baxter D, Ashburn A. Physiotherapy based on the Bobath Concept in stroke rehabilitation: a survey within the UK. Disabil Rehabil. 2001;23:254–262. PMid:11336098

Dobkin B. Clinical practice. Rehabilitation after stroke. N Engl J Med. 2005;352:1677–1684. PMid:15843670 PMCid:PMC4106469

Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004;22:281–299. PMid:15502272

Trachtenberg J, Chen B, Knott G, Feng G, Sanes J, Welker E, Svoboda K. Long-term in vivo imaging of experience-dependent synaptic plasticity in adult cortex. Nature. 2002;420:788–794. PMid:12490942

Kollen B, Lennon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke J, Halfens J, Geurts A, Kwakkel G, The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? American Heart Association, Stroke. 2009; 40:e89-e97.

Lubenova D, Titianova E, Neurorehabilitation. In Titianova E, et al, Textbook on nervous diseases - General Neurology. University Publishing House "St. Kliment Ohridski", 2015: 249-259. ISBN 978-954-07-3872-7.

Wade D. Measurement in neurological rehabilitation. University Press: Oxford, 1992.

Blum L, Bitensky N. Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review. Physical Therapy. 2008; 88(55):559–566. PMid:18292215

Berg KO, Maki BE, et al, Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992; 73(11): 1073-1080. PMid:1444775

Vasileva D, Lubenova D, Adapted program for independent home rehabilitation in patients with stroke in the chronic period. Sport and Science. 2014; 58(3):61-72. BPS OOD, Sofia. ISSN 1310-3393.

Veerbeek J, van Wegen E, van Peppen R, van der Wees P, Hendriks E, et al. What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis. PLoS ONE. 2014; 9(2): e87987.

Geurts A, de Haart M, van Nes I, Duysens I. A review of standing balance recovery from stroke. Gait Posture. 2005;22(3):267-281. PMid:16214666

Verheyden G, Vereeck L, Truijen S, et al. Additional exercises improves trunk performance after stroke: a pilot randomized con¬trolled trial. Neurorehabil Neural Repair. 2009;23(3):281-286. PMid:18955513

Saeys W, Vereeck L, Truijen S, Lafosse C, Wuyts F, Heyning P. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabil Neural Repair. 2012;26(3):231-238. PMid:21844283

Karthikbabu S, Nayak A, Vijayakumar K, et al. Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: a pilot rand¬omized controlled trial. Clin Rehabil. 2011;25(8):709-719. PMid:21504955

French B, Thomas L, Leathley M, Sutton C, McAdam J, et al., Repetitive task training for improving functional ability after stroke. Cochrane Database. Syst Rev: 2007; CD006073.

Lee T, Swanson L, Hall A, What is repeated in a repetition? Effects of practice conditions on motor skill acquisition. Phys Ther. 1991; 71: 150–156. PMid:1989010



How to Cite

Vasileva D, Lubenova D, Mihova M, Dimitrova A, Grigorova-Petrova K. Influence of Kinesitherapy on Balance Reactions in Patients with Ischemic Stroke in the Chronic Period. Open Access Maced J Med Sci [Internet]. 2015 Sep. 28 [cited 2022 Oct. 1];3(4):601-6. Available from:



B - Clinical Sciences

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